California Bill to Eliminate In-Office Exception Defeated!

This week, a California bill that would have eliminated the in-office ancillary services exception for advanced imaging technology was defeated after ASNC joined forces with other national and state specialty societies in a full-scale lobbying and grassroots effort. ASNC's lobbyist, Camille Bonta, led the Coalition of Patient-Centered Imaging in letters and communications to leaders of the California State Senate's Business, Professions and Economic Development Committee. In addition, ASNC launched a statewide grassroots effort and independently registered its profound opposition to SB1215 Committee.

The Committee voted against SB1215 on April 28, 2014. Ed Hernandez, the bill's sponsor, was the only affirmative vote on the measure.
The bill defined advanced imaging as magnetic resonance imaging, computed tomography, and positron emission tomography (PET)(SPECT was excluded from the definition).

ASNC continues to actively oppose a similar bill (H.R. 2914) pending in the U.S. House of Representatives that would eliminate the in-office ancillary services exception under Medicare and promises its vigilance in ensuring its members have the ability to provide unfettered and optimal care to patients nationwide. For the ASNC Talking Points, see below:

Issue: The American Society of Nuclear Cardiology (ASNC) urges CA legislators to oppose SB1215. SB1215 would eliminate the In-Office Ancillary Services Exception for advanced imaging. 

  • Improving quality for patients will require more care coordination, not less. The IOASE recognizes that referral within a group practice promotes continuity of care in a setting that is lower cost and more convenient to the patient.
  • SB1215 bases its concerns on language from a GAO report in Sept. 2012. However, SB1215 fails to point out that the report recommended that the IOASE should NOT be eliminated.
  • ASNC asserts the appropriateness of the imaging service, rather than site of the service, is the critical issue if there are concerns about utilization. ASNC and other medical societies have been proactive in making sure imaging tests are performed only in cases where they are appropriate. In fact, MedPAC, the advisory council to Congress, credits the recent 7 percent decline in imaging as due in part to increased awareness and initiatives, such as the Choosing Wisely Campaign, led by medical specialty societies like ASNC.
  • The marketplace should play a role where patients get their services. Private practice physicians are an integral part of our nation's healthcare system and often are the only medical providers in certain areas. Areas that are not served by large hospital systems would be hardest hit by curtailment  of in-office diagnostic imaging in the private practice setting.
  • The removal of the IOASE would unnecessarily interfere with the physician-patient relationship. Limiting the IOASE would force patients to receive ancillary services in a new and unfamiliar setting, increase inefficiencies, present significant barriers to appropriate screenings and treatments, and make health care less accessible.